Urine| Hair Follicle | Oral Fluid | Blood | ETG
Hair examination has emerged as an effective method for identifying drug and alcohol consumption. Hair strands offer an extended record of alcohol and drug use by trapping biomarkers within their fibers as they grow. When hair near the scalp is collected, it provides a detection timeline of up to three months for alcohol and drugs. Collecting hair is straightforward, somewhat resistant to tampering, and simple to transport.
A 1.5-inch segment of roughly 200 hair strands (resembling the size of a #2 pencil) from near the scalp yields 100mg of hair, the preferred amount for analysis and confirmation. For EtG, additional tests, and those exceeding 10 panels, a 150mg sample is advised. It's best to use a jeweler's scale to weigh the sample. If scalp hair is unavailable, a proportional amount of body hair can be used. Scalp hair specifically refers to hair on the head, while body hair includes other types like facial and axillary hair.
Process Overview
The primary steps in laboratory processing of drug test results include Accessioning, Screening, Extraction, and Confirmation.
Accessioning initiates with the entry of a sample into a laboratory's system. This step ensures the sample was sealed and sent properly, assigns it a random LAN (Laboratory Accessioning Number), and completes any extra data entry if not handled by an electronic chain of custody system.
Screening provides a preliminary rapid assessment for drugs of abuse. Though it's an economical means of excluding drug use in most samples, a positive result from Screening must be confirmed for legal purposes. Samples that are presumptively positive during Screening require a subsequent confirmation.
Should a sample be presumptively positive at the Screening stage, additional hair is sourced from the original specimen for Extraction. Here, drugs are removed from hair at a lower concentration than other methodologies (e.g., urine or oral fluid), which makes hair drug screening a challenging procedure.
Confirmation of positive Screening outcomes is done through GC/MS, GC/MS/MS or LC/MS/MS. All samples with presumptive positives are washed prior to confirmation if required. The full laboratory sequence from Accessioning to Confirmation is scrutinized under both the CAP (College of American Pathologists) Hair designation and ISO / IEC 17025 standard accreditation.
Advantages of hair drug testing:
Limitations:
Note: Despite being described as "hair follicle tests", the actual test evaluates the hair strand and not the follicle beneath the scalp.
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